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A single-arm clinical trial investigating the effectiveness of a non-hormonal, hyaluronic acid-based vaginal moisturizer in endometrial cancer survivors.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2020 Aug; Vol. 158 (2), pp. 366-374. Date of Electronic Publication: 2020 Jun 08. - Publication Year :
- 2020
-
Abstract
- Objective: To assess the efficacy of non-hormonal, hyaluronic acid (HLA)-based vaginal gel in improving vulvovaginal estrogen-deprivation symptoms in women with a history of endometrial cancer.<br />Methods: For this single-arm, prospective, longitudinal trial, we enrolled disease-free women with a history of endometrial cancer who underwent surgery (total hysterectomy) and postoperative radiation. Participants used HLA daily for the first 2 weeks, and then 3×/week until weeks 12-14; dosage was then increased to 5×/week for non-responders. Vulvovaginal symptoms and pH were assessed at 4 time points (baseline [T1]; 4-6 weeks [T2]; 12-14 weeks [T3]; 22-24 weeks [T4]) with clinical evaluation, the Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), Female Sexual Function Index (FSFI), and Menopausal Symptom Checklist (MSCL).<br />Results: Of 43 patients, mean age was 59 years (range, 38-78); 54% (23/43) were partnered; and 49% (21/43) were sexually active. VAS, VuAS, MSCL, and SAQ (Sexual Activity Questionnaire) scores significantly improved from baseline to each assessment point (all p < .002). FSFI total mean scores significantly increased from T1 to T2 (p < .05) and from T1 to T4 (p < .03). At T1, 41% (16/39) felt confident about future sexual activity compared to 68% (17/25) at T4 (p = .096). Severely elevated vaginal pH (>6.5) decreased from 30% (13/43) at T1 to 19% (5/26) at T4 (p = .41).<br />Conclusion: The HLA-based gel improved vulvovaginal health and sexual function of endometrial cancer survivors in perceived symptoms and clinical exam outcomes. HLA administration 1-2×/week is recommended for women in natural menopause; a 3-5×/week schedule appears more effective for symptom relief in cancer survivors.<br />Competing Interests: Declaration of competing interest Outside the submitted work, Dr. Jewell reports personal fees from Covidien/Medtronic. All other authors have no conflicts of interest to report.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Cancer Survivors
Cohort Studies
Endometrial Neoplasms physiopathology
Endometrial Neoplasms radiotherapy
Endometrial Neoplasms surgery
Female
Humans
Longitudinal Studies
Middle Aged
Prospective Studies
Vagina physiopathology
Vulva physiopathology
Endometrial Neoplasms rehabilitation
Hyaluronic Acid administration & dosage
Vagina drug effects
Vaginal Creams, Foams, and Jellies administration & dosage
Vulva drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 158
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32522420
- Full Text :
- https://doi.org/10.1016/j.ygyno.2020.05.025